Topotecan may be a better agent than paclitaxel for use in combination with cisplatin for multiple reasons. First, Kern et al demonstrated that paclitaxel may antagonize the activity of cisplatin. Second, topotecan has been demonstrated to be synergistic with both cisplatin and paclitaxel in vitro. It has been demonstrated that topotecan can dramatically potentiate the effects of platinum, perhaps by its ability to inhibit repair of platinum-DNA adducts.